Aims Clinical efficacy of endoscopic resection of early gastric cancer (EGC) with undifferentiated type histology are still under controversy. We aimed in this study to evaluate the clinical outcomes of endoscopic submucosal dissection (ESD) of EGC with undifferentiated type histology.
Methods We enrolled patients with EGC with undifferentiated type histology who underwent endoscopic submucosal dissection (ESD) at tertiary medical center. The clinical outcomes including curative resection rates and recurrence rates were retrospectively extracted and analyzed.
Results From 2007 to 2016, 75 EGCs with undifferentiated-type histology from 75 patients were identified. Mean age was 60.6 ±11.5 years and male were 46 (61.3%). Tumor location was most frequent at antrum (35/75, 46.7%), followed by corpus (20/75, 26.7%), angle (14/75, 18.7%) and high body and cardia (6/75, 8.0%). Mean tumor size was 18.2 ±7.8mm, and 17 (22.6%) showed submucosal invasion. Curative resection was estimated in 44 patients (58.7%). Among patients with non-curative resection, 6 patients (19.4%) underwent additional ESD, 8 (25.8%) additional surgery, and 17 (54.8%) was followed-up without additional treatment. After excluding 17 patients of follow-up loss more than 12month and additional surgery, recurrence was found in 2 patients (3.4%) during 55 (1-125) months (metachronous 1, distant metastasis 1). All the patients of recurrent cases were corresponding to non-curative resection and only observation was conducted.
Conclusions Due to lower curative resection rate, ESD for EGC with undifferentiated-type histology should be cautiously selected. In case of non-curative resection, additional treatment such as re-do ESD or surgery should be considered due to risk of recurrence.
